Whether or not we believe we should talk about sex with our therapist in treatment may have something to do with what we believe therapy is for or what the expected outcome is.
Are you going to therapy for a relationship issue? For a mental disorder such as depression or anxiety? To overcome trauma? Or because you are having a difficult time adjusting to a new situation? Therapy is useful for a multitude of issues, and no, sex may not be the most significant thing affected by a particular issue, but it definitely doesn’t hurt for the therapist to ask about it, to allow for the conversation to include some open, honest discussion not just about sex but also about sexuality, to at least let the client know it is okay to bring up the topic of sex in the therapist’s office.
Pervasive in our society is the inability to talk about sex, awkwardness, and embarrassment, which in turn leave us often bereft of the coping skills required to handle sexual issues in our relationship as they come up. When we avoid talking about sex with our partners, it can lead us down the path of avoiding talking about lots of other things as well. We all know that open, honest communication is key in successful relationships, so the absence of conversation and inability to talk about sex with our partners can be like a ripple effect in the breakdown of communication in a relationship. And when we go to therapy and our therapist also doesn’t feel comfortable talking about sex, the therapist in turn perpetuates what society has taught us—that sex is too taboo to talk about. This may be okay for some, but not for all. Some people want a more comprehensive experience. Some people want more than just a quick fix for their problems. Some people want to address the problems at their root. Some people want real change and real growth.
In treating relationships, sex must be addressed. Sex is not always everything, but in relationships it is definitely something. Most therapists treat some aspect of relationships. Even when an individual comes in for treatment for depression, anxiety, trauma, a new life situation, etc., if the person in therapy is involved in a relationship, or is dating, or even if they are single and celibate, a few questions encouraging open, honest communication about any concerns he/she has about sex can make all the difference in the world. Therapy should be a nonjudgmental safe haven where an individual can work stuff out, ask questions, and find answers. An avoidant therapist who is uncomfortable talking about sex sends a subtle message that can perpetuate feelings of shame, guilt, or embarrassment about sex, which in the end thwarts growth. Therapy should promote growth, not thwart it. In couples therapy, it is absolutely pertinent to ask about sex.
Feelings about our sexuality and our bodies are core in our lives. Many people walk around feeling bad about their desires or fantasies. Shame and guilt about sex are extremely common, and people have very little awareness of this. If a self-loathing, self-hating, guilt-ridden client comes to therapy, is it not best to address where the feelings come from? A client may not be that aware of the root of the problems. It is important for the therapist to open the door for exploration and discussion.
Therapists do not even have to be especially knowledgeable about sex. In fact, therapists rarely know anything about what the client has experienced, in terms of sex or any other aspects of the person’s life. Therapists are trained to ask questions in order to understand the client’s experience. The client is the expert on his or her experience. A therapist’s job is to ask questions and provide a nonjudgmental environment to foster the client’s growth. In looking at it from this model, therapists do not need to be well-versed in something to be open about it.
Therapy is a holistic health treatment that is helpful in guiding people to lead happier, healthier, genuine, and more honest lives all the way around. In therapy we attempt to break down the road blocks that prevent us from moving forward on our life journey, whether it be in our relationships at work or with our friends, family, or partner. Many psychological issues have a physical manifestation. It is important to remember that a sexual issue may be a representation of something bigger, stemming from depression, anxiety, or a relationship problem. We cannot treat problems in a vacuum. Mind and body are connected. When you leave sex out of treatment, the client’s journey remains incomplete.
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